Gastric Bypass Lowers Risk of Death - TIME

So in the well publicized studies on how weight loss surgery increases life expectency... one thing caught my eye:

"...after 10 years, bypass patients had maintained a 25% weight loss, compared to a 16% loss in patients who had stomach stapling, and 14% in those who underwent a banding procedure"

That sucks!

I agree, I believe that their statistics may be somewhat misleading because after the research that I have done on the web and at some doctor's offices, most patients have kept off anywhere from 40-50%of their excess weight.

I agree. In order for them to have been studying those 10 years out the people would have had to be banded 10 years ago. Figure another year for them to compile data and put it together that's 11 years (and that is conservative). The most common banding procedure done ANYWHERE at that time was the crappy band that was not adjustable and never worked well. It would be like getting a band today and never having a fill. What you came out of surgery with is all the restriction to be had. We call it "bandster hell" today. Those that have the non-adjustable band would be in bandster hell forever.

I wonder whether they looked at exercise as a factor. I remember seeing an interview with Sharon Osbourne. She was an early bandster and she said they just tightened her up and gave her no instructions...about eating, exercise, etc., and she actually lost her wieght way too quickly, and was generally anorexic for most of it.

The most common banding procedure done ANYWHERE at that time was the crappy band that was not adjustable and never worked well.

That's not true. The first Lap-Band (Bioenterics...which was bought by Inamed... which was bought by Allergan) was in use in Europe in 1994. The Obtech Swedish Adjustable Gastric Band was in use in the '80s. Both were adjustable... and were adjusted regularly.

Doesn't talk specifically about Obtech, but...

LAP-BAND® - ALB History

Broader history:

Adjustable gastric band - Wikipedia, the free encyclopedia

BTW, here's the abstract of the article. I'm not a subscriber, so I can't access the full article... but maybe Dr. Curry or somebody else will post it in the news section.

NEJM -- Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects

"Results The average weight change in control subjects was less than ±2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group,..."

So if one assumes that a person weighed 300 pounds at the beginning, after 1-2 years, they would have lost:

96 pounds with a RNY

75 pounds with a VBG

60 pounds with a Lap-Band/SAGB

After 10-15 years, they still would have kept off:

75 pounds with an RNY (Kept off 78% of their original weight loss)

48 pounds with a VBG (Kept off 64% of their original weight loss)

42 pounds with the Lap-Band or Swedish Band (Kept off 70% of their original weight loss)

That actually seems quite realistic/reasonable. On a positive note, if you lose 100 pounds, you have a good chance of keeping off at least 70 of those pounds long-term. A hell of a lot better than any diet offers!

I would be interested to note if the banded patients in the study were with adjustable lap bands. If not then eventually you might lose restriction. I know that a friend of mine had lap band six years ago and she did not have access to the adjustable band at that time. Being able to adjust would make a difference I would think.

Linda

They are adjustable bands. They have the non-adjustable Band, VBG, as a separate category.

Just my first observation is they said 'banding procedure', not 'adjustable banding procedure'.. and when I read news articles about lap-band they always refer to it as 'adjustable banding procedure'..

I may get flamed for this...... but I think if you are LOOKing for the negative.. you will find it.

I choose to look for the positive, because I WILL FIND IT.

That's not true. The first Lap-Band (Bioenterics...which was bought by Inamed... which was bought by Allergan) was in use in Europe in 1994. The Obtech Swedish Adjustable Gastric Band was in use in the '80s. Both were adjustable... and were adjusted regularly.

Doesn't talk specifically about Obtech, but...

LAP-BAND® - ALB History

Broader history:

Adjustable gastric band - Wikipedia, the free encyclopedia

I could have well missed it but where does it explain how many adjustable bands were done vs. non-adjustable bands during that time frame?

They were all adjustable bands... those are the only kind that Bioenterics and Obtech made.

Non-adjustable Bands are only associated with the VBG. Those were in a separate category (that sadly did slightly better than adjustable Bands).

From the History of the Lap Band Page (1st link):

June 1986 First use of open adjustable silicone gastric banding (ASGB)

September 1993 First laparoscopic adjustable gastric band used in Europe

But the article doesn't say what bands they are studying. The studies you show don't offer a lot of details such as who specifically was studied. Are they following up those that eroded or had other complications? Who is their target group, everyone who was banded or one city of banded people or who. People whose band was placed with the old technique or the current technique? There are a lot of missing details.

Those stats just don't work with what is going on today. I'd have to see a lot more details and how they formed their numbers before I'd buy into that. It was just 5-10 years ago that they were sewing the band into place much differently than today and people did not do well. They were slipping and eroding. Today it isn't the same problem by any stretch. Ten years ago they didn't have the various sizes of bands we have today. That's a huge issue right there.

So there are soooo many variables. The problem with 10 year stats and the band is that ... there aren't any. The bands used today are different, the technique for placing the bands is different, there are no 10 year stats for today's bands and today's surgical techniques. So I can't possibly put any stock into their studies.

I think the reason we're adament about this is that we don't want it to be true since we all have a vested interest in the band succeeding...but also because from the people we know and from our own experiences, it just plain isn't true.

I think the reason we're adament about this is that we don't want it to be true since we all have a vested interest in the band succeeding...but also because from the people we know and from our own experiences, it just plain isn't true.

As somebody who has been banded for 6 years, and has friends who were Banded in the Trials, I have to disagree. I think that the statistics sound very true to me. If you look at a previous post of mine, this means that a 300 pound person managed to lose 60 pounds and keep off 70% of that over the course of 10 years. That's not too shabby, actually.

Remember, averages for the Band are in the 50-60% of EWL at 1-2 years. So, a 300 pound person, probably needs to lose 120-130 pounds. That would put them at losing 60-70 pounds... and hopefully, if they kept off 70% of that for 10 years they'd be doing very well. Most long-term Bandsters that I know end up with reflux issues and such that causes them to have small unfills and such. So, a small regain is not unusual.

As somebody who has been banded for 6 years, and has friends who were Banded in the Trials, I have to disagree. I think that the statistics sound very true to me. If you look at a previous post of mine, this means that a 300 pound person managed to lose 60 pounds and keep off 70% of that over the course of 10 years. That's not too shabby, actually.

Remember, averages for the Band are in the 50-60% of EWL at 1-2 years. So, a 300 pound person, probably needs to lose 120-130 pounds. That would put them at losing 60-70 pounds... and hopefully, if they kept off 70% of that for 10 years they'd be doing very well. Most long-term Bandsters that I know end up with reflux issues and such that causes them to have small unfills and such. So, a small regain is not unusual.

Again you prove my point. During the trials the bands were not placed the same as today. There ARE NO 10 YEAR STATS for the technique of today. You continue talking about how today's band is not great because of the way they did things a long time ago. It's like saying surgery today doesn't work because in the 1800s people died from surgical complications. One has nothing to do with the other. It simply isn't accurate. They recognized a problem during the trials and so far everything you have provided is based on the old bands and old techniques. Your numbers still don't answer a lot of questions about how they came to those numbers to begin with. We don't know how the people were picked, did they all belong to a small group of doctors (likely so), were those docs any good? Did they have much experience with the band, what surgical technique did they use... I could go on all day long.

So your numbers just don't work anymore because those techniques are no longer used.

I think if you want to only find the negative and the bad, that's what you'll find. That does seem to be your focus and I don't really understand why. We shouldn't be looking for all negatives, we should be looking for a reasonable balance as that is closer to fact than focusing on all negatives or all positives.

Regardless, there still aren't any 10 year stats for todays methods. They haven't been around for 10 years.

With that said I do believe Inamed fudges their stats a bit, I don't buy the 1.3% erosion stats although I suspect that one might be close but I darn sure don't buy the 3% slip stats. They are finally coming clean and suggesting slips are closer to the 7% rate and that seems more reasonable. But in the beginning they were out to prove their product and just a most drug co's or businesses, they did what they had to, to make the product look more promising than it was. I think if you balance that with all the negatives you find, there might be some truth in the balance somewhere.

For now it is the best and most safe surgical procedure I am aware of available today. That's all I can ask for as a patient.

I'm going to agree with WABB here. It's a well-known fact that over the last several years, the techniques used for banding have evolved and improved, resulting in increased success and fewer complications. Statistics from a study that was begun well over 10 years ago, using techniques that are now considered to be dated, simply aren't applicable to today's Lap-Band surgery.

So while I wouldn't necessarily ignore this study, I'd definitely take it with a very large grain of salt. I prefer this study, which looked at all studies published in English-language journals up to September 2005 that had more than 100 participants and at least 3 years follow up.